Mapping the Caregiver Experience in a Canadian Province: Research Methodology for the Saskatchewan Caregiver Experience Study.

BACKGROUND: Policies and services for older adults are increasingly focused on living in the community, rather than relying on institutions. A total of 70-80% of community care for older adults is provided by family and friend caregivers. With Canada's aging population, the number of caregivers to older adults is growing. PURPOSE: The purpose of this paper is to describe the research methodology that was employed in the Saskatchewan Caregiver Experience Study. The methodology was used to map the experiences and gather perspectives of caregivers in Saskatchewan and to identify their priority support needs. METHODS: Qualitative description was the approach in this study. An online qualitative survey was administered via SurveyMonkey and distributed via Facebook and community newsletters. The survey collected caregiver demographics and asked three open-ended questions regarding: (1) the challenges that caregivers experience; (2) the positive aspects of caregiving; and (3) the support needs and priorities of Saskatchewan caregivers. A fourth question where caregivers could freely express any other experiences or perspectives was included. Content analysis was the method used for data analysis. RESULTS: 355 individuals met the inclusion criteria for this study. Participants were evenly distributed amongst urban-large, urban-small/medium, and rural settings in Saskatchewan. The average age of caregivers and care recipients were 61 and 83 respectively. CONCLUSION: This study has implications for research, practice, and policy. By gathering the full spectrum of the caregiver experience in Saskatchewan, this study can help to inform how communities, governments, and our healthcare system can best support caregivers in their role.

Championing Dementia Education: Adapting an Effective Scottish Dementia Education Program for Canadian Acute Health Care Providers.

With increasing numbers of persons living with dementia and their higher rates of hospitalizations, it is necessary to ensure they receive appropriate and effective acute care; yet, acute care environments are often harmful for persons with dementia. There is a lack of dementia education for acute health care providers in Canada. Scotland presently delivers a dementia education program for health care providers, known as the Scottish National Dementia Champions Programme. The objective of this Policy and Practice Note is to present the collaborative work of Scottish experts and Canadian stakeholders to adapt the Dementia Champions Programme for use in Canada. This work to date includes: (a) an environmental scan of Canadian dementia education for acute health care providers; (b) key informant interviews; and, (c) findings from a two-day planning meeting. The results of this collaborative work can and are being used to inform the next steps to develop and pilot a Canadian dementia education program.

Application of nursing presence to family-centered care: Supporting nursing practice in pediatric oncology.

PURPOSE: In pediatric care settings, family-centered care (FCC) is an integral way to ensure family involvement in their child's care and has been known to improve health outcomes and families' psychosocial well-being. Similarly, nursing presence is deemed beneficial in the formation of authentic nurse-patient relationships and is known to facilitate healing and improve satisfaction for the patient and their family. The objective of this article is to explore how nursing presence supports FCC by closely examining the four concepts of FCC as described by Institute for Patient- and Family-Centered Care: dignity and respect, information sharing, participation, and collaboration. A case study is also presented to demonstrate how nursing presence can be applied in FCC, when caring for a pediatric oncology patient. CONCLUSION: Nursing presence is essential in FCC since it plays a key role in the formation of relationships, a fundamental element in the four concepts. Attributes of nursing presence can be interwoven in the FCC framework and have positive clinical, social, and emotional outcomes for the patient and family. Although literature has explored associations between FCC and nursing presence, there is need for more scientific research to justify this argument to support the improvement of quality of family nursing care and strengthen the FCC model. PRACTICE IMPLICATIONS: The four concepts of FCC lay a foundation for a model of care that can be enhanced by nursing presence, potentially providing a remedy for depersonalization of healthcare by improving nurse patient relationships in pediatric care settings. Nursing presence becomes less ambiguous when enacted in a FCC framework, revealing attributes that may be cultivated in family nursing to improve therapeutic relationships among nurses and family caregivers.

Caregivers to older adults require support: A scoping review of their priorities.

The vast majority of older adults who are chronically ill rely on informal caregivers for support. Caregivers often require additional support to facilitate their role. To the best of our knowledge, there has yet to be a collation of caregiver-identified priorities for support. Using existing research, this scoping review provides a comprehensive picture of what caregivers have indicated as priorities for support. Arksey and O'Malley's scoping review framework guides this review. We searched MEDLINE, CINAHL and PsycINFO databases on July 2, 2021. We selected databases based on their relevance to nursing, health and social science. Inclusion criteria were peer-reviewed research of any design, a sample population of caregivers to older adults (>55 years), manuscripts published in English and the priorities for caregiver support identified by caregivers themselves. We screened a total of 3591 records, and 33 articles met the inclusion criteria. These studies were from geographic settings across the globe and used various quantitative, qualitative and mixed-method study designs. In our synthesis, we quantified the identified priorities within the studies using coding and content analysis. We present the following list of caregiver-identified priorities: (1) orientation to the caregiving role; (2) self-care and respite; (3) adapting healthcare; (4) improved supports; (5) information needs; (6) access to resources; (7) financial assistance. Policymakers, healthcare professionals and non-profit organisations can use evidence from this review to guide decisions when developing support services and interventions for caregivers.

Type 1 diabetes management responsibilities between adolescents with T1D and their parents: An integrative review.

PURPOSE: Diabetes self-management for adolescents with type 1 diabetes (T1D) is a complex and multifaceted process that requires careful consideration of a supportive or shared approach to care. The purpose of this review was to synthesize the qualitative and quantitative evidence regarding the nature of adolescent-parent interactions and relationships in the context of T1D management. Of particular interest was the role of interdependence in this relationship. METHODS: An integrative review of the literature was conducted between January 2021 and April 2021 using Whittemore and Knafl's (2005) methodological strategies. RESULTS: Eleven studies published between 2003 and 2018 met the review criteria. Thematic analysis identified the following three themes related to parent-adolescent relationships in care including the Effectiveness of Parental Involvement and T1D Management, Shared Responsibility and T1D Task Management, and Gaining Independence in T1D Management. This review highlights the importance of both parent and adolescent shared involvement in T1D management. In particular, parental involvement appears necessary for improved glycemic control, better adherence to the T1D management regime, and for practicing self-management in adolescents with T1D. PRACTICE IMPLICATIONS: Better understanding of the parent-child interaction in diabetes care will provide important information to aid family nurses to identify, support, and help maintain the sharing of T1D management responsibilities between parents and their adolescents.

Assessing the Need for Caregiver Support in Saskatchewan, Canada: Gathering Perspectives and Setting Priorities.

Background: An ageing population corresponds with a need for informal caregivers. Caregiving burden is the most compelling problem affecting caregivers of older adults. Previous research efforts have explored predictors of caregiving satisfaction and interventions for caregiving support. Our study aimed to set priorities for the future development of interventions for caregivers in Saskatchewan. Our objective was to engage caregivers in setting priorities for accessible interventions and support. The specific research question we sought to answer was: "What do the experiences of caregivers have to offer in setting priorities for caregiver support?" Methods: We conducted an environmental scan of caregiver intervention programming in Canada. We then held two focus groups with caregivers to older adults, defined as 55 years or older for this study. Twenty-three caregivers attended the first focus group, and 10 caregivers participated in the second. We used a qualitative descriptive approach and data were analyzed using thematic analysis. Results: Caregivers of older adults were eager to share barriers and facilitators of their role. Themes derived from data include: 1) lack of access; 2) conflict with self and others; 3) the burden of caregiving; and 4) declining health and wellness. Conclusion: Caregivers may struggle to find resources to support them in their caregiving role. Findings from this study indicate that there is a need for more interventions to support caregivers. Furthermore, our data highlight what outcomes caregivers in Saskatchewan want from those interventions.

Managing the unmanageable through interdependence in adolescents living with type 1 diabetes and their parents: A constructivist grounded theory.

BACKGROUND: Management of T1D is complex and requires continuous care and monitoring that place many demands on adolescents with T1D and their parents. The purpose of this study was to explore the nature of interdependence with T1D management with adolescents and their parents. METHODS: Using a constructivist grounded theory methodology, 32 open-ended interviews were conducted, transcribed, and analyzed from 11 adolescents aged 10-18 years with T1D and eight parents. FINDINGS: The data were coded using three coding phases: initial, focused, and theroetical and this process continued until theroetical saturation was reached. The substantive theory that emerged from the data describing parents' and adolescents' main concern of Maintaining Optimal Glycemic Control was Managing the Unmanageable through Interdependence. Four related subprocesses were found: Completing T1D Tasks, Attaining Support, Balancing Independence, and Reconciling Reality. These subprocesses occurred within the context of the ever-changing, Nature of the Illness. DISCUSSION: There is a dynamic relationship associated with interdependence between adolescents with T1D and their parents that varied situationally and by age. Participants also indicated interdependence occurs or they would like it to occur, with others beyond themselves and the health-care team to others willing to be involved. APPLICATION TO PRACTICE: Interdependence is a dynamic process and requires ongoing evaluation by health-care professionals of its function in the daily management of T1D by parents and adolescents. Additional research into of the roles of health professionals and others in promoting interdependence is needed.

Exploring nursing presence as experienced by parents in pediatric oncology.

BACKGROUND: Nursing presence has been viewed as a valuable way to create therapeutic relationships and has been linked to better health outcomes for patients and families. However, whether nursing presence can be described and how parents in pediatric oncology experience this phenomenon remains unanswered. Therefore, the purpose of this study was to explore how parents of children with cancer describe and experience nursing presence. METHODS: This study used Giorgi's phenomenological approach to explore nursing presence as experienced by parents of children with cancer. Ten participants from a pediatric oncology clinic in Canada were interviewed. Giorgi's approach was used to analyze these data. FINDINGS: Based upon participants' descriptions, a structure of nursing presence emerged which included six constituent features: An attitude of presence, a source of encouragement, clinical experience and expertise, therapeutic communication, family involvement, and a sense of home away from home. Most notably, nursing presence as experienced by parents was characterized by the 'being' and 'doing' of presence which were equally important. CONCLUSION: The experiences described by parents provided rich and nuanced insights into what it meant to experience nursing presence in a pediatric oncology setting. This study provides a structure for this meaning making and expounds on its constituent features, describing what nursing presence resembles when experienced by parents of children with cancer. PRACTICE IMPLICATIONS: This study informs nursing practice, policy, and education in ways that are likely to enhance care and the subsequent well-being of pediatric oncology patients and families.

Mental Health and Addiction Related Emergency Department Visits: A Systematic Review of Qualitative Studies.

Mental health and addiction (MHA) related Emergency Department (ED) visits have increased significantly in recent years. Studies identified that a small subgroup of patients constitutes a disproportionally large number of visits. However, there is limited qualitative research exploring the phenomenon from the perspectives of patients who visited ED frequently for MHA reasons, and healthcare providers who provide care to the patients since the overwhelming majority of studies were quantitative based on clinical records. Without input from patients and healthcare providers, policymakers have inadequate information for designing and implementing programs. The purpose of this study was to systematically review the literature of qualitative research on frequent MHA related ED visits. The findings of the review revealed that a lack of community resources and existing community resources not meeting the needs of patients were critical contributing factors for frequent MHA related ED visits.

Keeping Hope Possible Toolkit: The Development and Evaluation of a Psychosocial Intervention for Parents of Infants, Children and Adolescents with Life Limiting and Life Threatening Illnesses.

BACKGROUND: Globally, many infants and children are diagnosed with illnesses that impose limitations on their well-being and life course trajectory. Children's care becomes the central focus of family life. Inadequate support for parents is detrimental to their well-being and management of their child's care and support needs. METHODS: The second phase of this evaluation study followed a quasi-experimental crossover design to test a theory-based psychosocial intervention, the Keeping Hope Possible Toolkit. Fifty-nine participants were randomly assigned to one of two sequence groups, with measures of hope, feelings of control, distress, and uncertainty completed pre- and post-intervention, and at a three-month follow-up. Qualitative interviews sought to assess participant experiences with the intervention, along with acceptability and feasibility. RESULTS: Significant influence on parental distress was found, and the qualitative findings reveal benefits of the intervention for parental wellbeing. The intervention effectively offered practical and emotional support to diverse family caregivers. CONCLUSIONS: The evidence-informed KHP intervention can be used by healthcare providers to intervene with family caregivers to support their dynamic emotions including hope, need to live in the moment and remember self, and social preferences. In doing so, parents' critical caregiving activities can be sustained and their child's health and wellbeing optimized.

Seeking Divine Intervention to Manage the Advanced Stages of Breast Cancer in Southwestern Nigeria.

BACKGROUND: The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES: To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS: Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS: Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION: Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE: Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

Development of a bereavement intervention for spousal carers of persons with dementia: The Reclaiming Yourself tool.

A dearth of supportive interventions exists for bereaved spouses who were carers of persons with dementia, despite an identified need for such supports. The purpose of the current work was to develop and evaluate a supportive writing intervention for this population that was informed by the experiences of spouses who were bereaved and was specific to the unique context of dementia. Following development of the Reclaiming Yourself tool, a mixed methods design was utilized to assess its effects on grief, depressive symptoms, and balance between restoration and loss. Fifteen participants residing in Saskatchewan and Manitoba were provided the writing intervention and visited three times approximately four weeks apart, completing quantitative measures (for grief, depressive symptoms, and finding balance) at each visit and an exit interview about the intervention. Paired-sample t-tests illustrated trivial effect sizes and no significant differences in grief, depressive symptoms, or balance orientation, with overall means suggesting low levels of depressive symptoms and grief, and a slight orientation towards restoration. Thematic analysis illustrated benefits from the tool, with participants reporting that it provided a structured approach to grief, was a catalyst for emotional expression, and facilitated reflection. The format and timing of the intervention was not ideal for all participants. Although Reclaiming Yourself did not affect quantitatively measured grief, depressive symptoms, and balance, carers accrued benefits from the tool that align with beneficial processes observed in other writing interventions. While more research on the effectiveness of this tool is needed, such interventions are valuable to support the well-being of carers who are bereaved following the death of a spouse with dementia.

Palliative and Hospice Care in Correctional Facilities: Integrating a Family Nursing Approach to Address Relational Barriers.

BACKGROUND: The need for palliative and hospice care for persons with life-limiting conditions who are incarcerated is increasingly common in correctional facilities worldwide. OBJECTIVE: Through a family nursing lens, we critically analyze the unique challenges experienced by those requiring palliative care while incarcerated. Key concerns and implications for nursing are illustrated through the discussion of a representative case scenario. METHODS: The case scenario was developed based on the findings of a scoping review of academic and gray literature (such as policy documents and editorials) about palliative, hospice, and end-of-life care in corrections. RESULTS: The case scenario highlights multilevel barriers that were identified, including the individual, relational, institutional, and sociocultural contexts of palliative care in correctional facilities. Evidence is presented of how integration of a family nursing perspective can enhance specialized palliative and hospice care services in correctional settings. CONCLUSIONS: By applying a family nursing approach, nurses practicing with correctional populations can ensure persons with life-limiting illnesses are not denied their right to appropriate end-of-life care by playing a key role in addressing barriers to palliative and hospice care access in corrections. Specific attention to relational issues and holistic care can contribute to enhanced palliative and hospice care, greater dignity in dying, and improved family and peer outcomes, which have benefits for individuals, families, communities, and society. IMPLICATIONS FOR PRACTICE: Through the case scenario, we illustrate real issues emerging in correctional contexts and offer evidence of how family nursing relational principles can be applied to promote adequate palliative and hospice care.

The Experiences of Women Living With Cervical Cancer in Africa: A Metasynthesis of Qualitative Studies.

BACKGROUND: Cervical cancer is the fourth most common cancer in women worldwide. However, developing countries bear 85% of the burden, with Africa sharing the highest incidence with Melanesia. OBJECTIVES: The aims of this study were to explore the experiences of women living with cervical cancer in Africa and to inform others of the extent of the work done in this field of study by synthesizing the findings of qualitative research. METHODS: The work of Sandelowski and Barroso guided the study, and 6 databases were searched to identify relevant studies using the key words Africa, cervical cancer, and experiences. RESULTS: A total of 13 studies (n = 13) met the inclusion criteria, and their findings were synthesized. The studies originated primarily from South Africa and focused on the period from diagnosis to 1 year after completing curative treatment. One overarching core theme living a life of suffering, 2 main themes, architects of suffering and mediators of suffering, and 9 subthemes were identified. CONCLUSION: Women living with cervical cancer in Africa live a life of suffering, which starts when they experience the first symptom of cervical cancer and continues well after completing treatment. The facilitators of suffering outweighed the mediators and could not be guaranteed, as it did not relieve the suffering of all. IMPLICATIONS FOR PRACTICE: Nurses practicing in Africa should be acutely aware of cervical cancer and do their utmost within their limited resources to prevent and detect the disease in its earliest stage. Religious and support interventions could be used to lessen the suffering of these women.

Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing.

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person-centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions.

The role of Internet cancer information for older adults with cancer: Perspectives of older adults and healthcare professionals.

OBJECTIVE: Older adults with cancer have unique information and supportive care needs. There is a growing body of literature regarding the use of Internet health information, but less is known about the use of the Internet for cancer information amongst older adults with cancer. MATERIALS AND METHODS: This is a secondary analysis of qualitative data from a mixed-methods study of the use of cancer-related Internet information amongst adults with cancer. In the present study, we include transcripts from two samples: 34 interviews with adults over age 55 (n = 17) with cancer, and interviews and focus groups with healthcare professionals (n = 21). Data were analysed using thematic analysis with an interest in age-related themes. RESULTS: Our findings are grouped into three main themes: (a) independently augmenting healthcare services and supports; (b) supporting and situating information; and (c) mobilising family and support networks. Patients and healthcare providers described cancer-related Internet information as a beneficial resource to address gaps in information and supplement information from healthcare professionals from diagnosis and throughout treatment. Older adults reported using cancer-related Internet information to manage their cancer experience, although sometimes feeling technologically hesitant. However, healthcare professionals felt older adults were less likely than younger patients to seek cancer information from the Internet. CONCLUSION: The use of cancer-related Internet information is growing amongst older adults with cancer. Older adults mobilise technology uniquely. Healthcare professionals can support these efforts by being aware and through initiating dialogue about information preferences.

Family caregiving for persons with advanced heart failure: An integrative review.

OBJECTIVE: The unique needs of caregivers of those with advanced heart failure (HF) are not effectively being met, and reports of physical and mental health challenges are common. The objective is to identify the current state of the literature related to family caregivers of persons with advanced HF, ascertain gaps that require further exploration, and provide preliminary practice recommendations based on the results. METHOD: Systematic review of quantitative and qualitative literature. A search of CINAHL, Medline, EMBASE, and PubMed identified 24 articles that met inclusion criteria. Data were analyzed using the constant comparison method and coded. Thematic analysis was used to develop themes. RESULT: Sixteen qualitative and seven quantitative studies met inclusion criteria. Analysis of these studies identified six key areas: (1) undertaking a journey in a state of flux, (2) gaining strength, (3) forgetting oneself along the way, (4) seeking out sources of support, (5) preparing for end of life, and (6) finding closure. SIGNIFICANCE OF RESULTS: The healthcare system currently struggles to meet the care demands of patients with chronic conditions such as advanced HF; as such, informal caregivers are undertaking key roles in the management of symptoms and promotion of the health of those with advanced HF. When caregivers are not adequately prepared for their role, both patient and caregiver well-being is compromised; therefore, a deeper understanding of the caregiving experience could assist in identifying the cause of caregiver anxiety and result in the development of strategies to minimize its effects. Overall, this review will also contribute to improving the current practice when working with caregivers of persons with advanced HF and serve as a basis for development of evidence informed interventions in the future.

Managing Cancer Experiences: An Interpretive Description Study of Internet Information Use.

BACKGROUND: People with cancer increasingly use the Internet to find information about their illness. However, little is known regarding people's use of cancer-related Internet information (CRII) to manage their patient experience, defined as patients' cumulative perceptions of interactions with the healthcare system during their illness. OBJECTIVE: The purpose of this study was to create an understanding of CRII use by people newly diagnosed with cancer and how it shapes their patient experience and informs their interactions with healthcare professionals and healthcare services. METHODS: An embedded mixed design guided this study. Nineteen people with cancer were interviewed twice and completed a survey about CRII use. Qualitative data were analyzed using thematic analysis. Descriptive statistics summarized the quantitative findings. RESULTS: Participants of all ages and educational levels reported using CRII as a pivotal resource, across the cancer trajectory. Cancer-related Internet information played a central role in how patients understood their illness and when they sought and used healthcare services. Two themes emerged based on patient interviews: (1) person in context and (2) management of information. CONCLUSION: Cancer-related Internet information plays a crucial role in how people manage their illness and take control of their patient experience. Participants used CRII to learn about their illness, support their efforts to self-manage, and complement information from professionals. IMPLICATIONS FOR PRACTICE: Individuals and institutions can promote and encourage tailored CRII use by engaging patients and suggesting websites based on their needs. Doing so may create efficiencies in service use and empower patients to be more involved in their own care.

Exploring Women's Support Needs After Breast Reconstruction Surgery: A Qualitative Study.

BACKGROUND: The procedures for breast reconstruction (BR) after mastectomy frequently initiate a difficult recovery period. A better understanding of women's support needs after surgery would improve patient care. OBJECTIVE: The aim of this study was to identify patients' support needs after BR. METHODS: In a retrospective study design, 21 participants described their support experiences after BR, including their sources of support and the impact of support on their recovery in a semistructured interview. Transcriptions of the interviews were analyzed using thematic analysis. RESULTS: Four support needs were identified and were composed of elements of instrumental, emotional, and informational support. These needs were addressed to varying degrees by healthcare providers, family members, and other women who had BR experience. CONCLUSION: Women's experience of BR and their ability to cope are markedly better when their support needs are effectively addressed. Greater attention to their needs for support has the potential to improve patient care. IMPLICATIONS FOR PRACTICE: Nurses play a pivotal role in providing information to women who are recovering from BR. Improved access to communication channels between nurses and patients would likely improve patients' support experiences. In addition, nurses can assess the women's specific support needs and partner with families to help them understand how best to support women during recovery.

Patient Information Needs and Breast Reconstruction After Mastectomy: A Qualitative Meta-Synthesis.

BACKGROUND: Although many women benefit from breast reconstruction after mastectomy, several studies report women's dissatisfaction with the level of information they were provided with before reconstruction. OBJECTIVE: The present meta-synthesis examines the qualitative literature that explores women's experiences of breast reconstruction after mastectomy and highlights women's healthcare information needs. METHODS: After a comprehensive search of 6 electronic databases (CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus), we followed the methodology for synthesizing qualitative research. The search produced 423 studies, which were assessed against 5 inclusion criteria. A meta-synthesis methodology was used to analyze the data through taxonomic classification and constant targeted comparison. RESULTS: Some 17 studies met the inclusion criteria, and findings from 16 studies were synthesized. The role of the healthcare practitioner is noted as a major influence on women's expectations, and in some instances, women did not feel adequately informed about the outcomes of surgery and the recovery process. In general, women's desire for normality and effective emotional coping shapes their information needs. CONCLUSION: The information needs of women are better understood after considering women's actual experiences with breast reconstruction. It is important to inform women of the immediate outcomes of reconstruction surgery and the recovery process. IMPLICATIONS FOR PRACTICE: In an attempt to better address women's information needs, healthcare practitioners should discover women's initial expectations of reconstruction as a starting point in the consultation. In addition, the research revealed the importance of the nurse navigator in terms of assisting women through the recovery process.