Healthy siblings' perspectives about paediatric palliative care: A qualitative systematic review and meta-synthesis.

BACKGROUND: Siblings of children requiring palliative care are often forgotten and overlooked, as the focus tends to be on the ill child and their parents. Limited knowledge of non-bereaved siblings' perspectives makes it challenging to provide appropriate support for them. A review of existing literature is thus needed to better understand the experiences of these siblings and to identify research gaps that may require further examination. AIM: To consolidate the available qualitative evidence on the perspectives of non-bereaved healthy siblings regarding paediatric palliative care. DESIGN: A qualitative systematic review using a meta-synthesis approach was conducted. DATA SOURCES: Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus and ProQuest Dissertations and Theses Global) were searched from each database's inception date until October 2022. The search included qualitative and mixed-method studies that reported the perceptions and associations of siblings of patients receiving paediatric palliative care. Data were synthesised using thematic analysis. RESULTS: Eleven studies were included. The overarching theme of the review would be 'A walking shadow: Living in the darkness shaped by the dying sibling', and three key themes and nine subthemes were identified from the included articles: (1) Changing family dynamics; (2) Impact on school and socialisation and (3) Psychological impact and coping. CONCLUSION: Siblings demonstrated negative psychological impacts and were affected by changing family structure and relationships. However, socialisation with society, and varied coping skills such as cognitive coping and using distraction techniques, were significant for siblings to go through this journey and even led to some positive outcomes for them.

Effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder among nurses: A systematic review and meta-analysis.

AIMS AND OBJECTIVES: The aim of this study was to investigate the effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder symptoms among working registered nurses. BACKGROUND: Nurses account for nearly half of the global healthcare workforce and are considered significant contributors in multi-disciplinary healthcare teams. Yet, nurses face high levels of psychological distress, leading to burnout and post-traumatic stress disorder. Mindfulness-based training is a strategy that has been introduced to foster a state of awareness of present physical, emotional and cognitive experiences to regulate behaviour. DESIGN: This systematic review of randomised controlled trials was designed according to PRISMA guidelines. Eligible studies were screened and extracted. Methodological quality was evaluated by two researchers, independently. RevMan 5.4 was used to conduct the meta-analysis. RESULTS: Fourteen studies including a total of 1077 nurses were included, of which only eleven were included in the meta-analysis as the remaining had missing or incomplete data. Meta-analysis revealed that MBI was more effective than passive comparators in reducing psychological distress, stress, depression and burnout-personal accomplishment. When compared to active comparators, MBI was also found to be more effective in reducing psychological distress and was as effective in reducing stress, anxiety, depression and burnout. Evidence on the effects of MBIs on PTSD was scarce. CONCLUSION: Mindfulness-based interventions can effectively reduce psychological distress, stress, depression and some dimensions of burnout. However, evidence remains scarce in the literature. There is a need for more methodologically sound research on mindfulness-based training among nurses. RELEVANCE FOR CLINICAL PRACTICE: An important aspect that relates to the success of mindfulness-based interventions is the continued and dedicated individual practice of the skills taught during mindfulness training amidst demanding clinical work environments. Therefore, relevant support for nurses must be accounted for in the planning, design and implementation of future mindfulness-based interventions.

Fathers' breastfeeding knowledge, attitudes, and involvement in the Asian context: A mixed-studies review.

BACKGROUND: Despite numerous initiatives attempting to enhance BF across Asia, recent studies show that exclusive BF rates remain alarmingly low. With globalization, society has shifted from traditional family roles towards more egalitarian marriages, where Asian fathers are now more involved in parenting. As fathers' involvement in breastfeeding is highly complex and context-sensitive, evaluation of a wide range of concepts and evidence within the Asian context is necessary. OBJECTIVE: This review aims to consolidate and appraise empirical studies exploring fathers' breastfeeding knowledge, attitude, and involvement within the Asian context. DESIGN: A systematic mixed-studies review was conducted. Six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus, and ProQuest Dissertations and Theses Global) were searched from each database's inception date until June 2022. Studies were appraised using the Mixed Method Appraisal Tool and data was synthesised using the results-based convergent integration method. FINDINGS: Twenty-two studies were included in this review. The synthesis of findings identified two main themes and six sub-themes. KEY CONCLUSIONS: Asian fathers have a varied understanding of breastfeeding and their involvement in breastfeeding is influenced by personal, cultural, religious, social, and environmental factors. IMPLICATIONS FOR PRACTICE: Perinatal care professionals play a crucial role in engaging and enhancing fathers' involvement in breastfeeding education programmes. The findings also urge policymakers to introduce more 'father-friendly' breastfeeding guidelines and educate perinatal care professionals to be more aware and sensitive to the needs of fathers. There is also a need to introduce more flexible and economically sensitive paternal leave policies to improve fathers' breastfeeding involvement.

Learning styles, preferences and needs of generation Z healthcare students: Scoping review.

AIM: This scoping review aimed to consolidate evidence of the learning styles, preferences and needs of Generation (Gen) Z healthcare students. BACKGROUND: It is essential to update the educational framework and pedagogy to meet each generation's distinct learning styles and preferences. DESIGN: A scoping review of published and unpublished data. METHODS: Six electronic databases (PubMed, Embase, CINAHL, PsycINFO, ProQuest and Scopus) were searched for studies written in English from June 2016 to July 2021. The Arksey and O'Malley (2005) five-stage framework was adopted to guide this review: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; and (5) collating, summarising and reporting the results using a thematic analysis. RESULTS: Seventeen studies were included and based on the thematic analysis, four themes were identified: (1) attributes of Gen Z healthcare students; (2) learning styles of Gen Z healthcare students; (3) learning preferences and needs of Gen Z healthcare students; and (4) teaching the Gen Z healthcare students: future directions and recommendations for educators. The findings implied more culturally diverse studies that adopt the mixed-methods or qualitative design are needed to capture deeper insights about Gen Z and in examining the effectiveness of technology integration and digital storytelling to boost students' learning and confidence in their future careers. CONCLUSIONS: Technology, campus resources and self-care strategies must be carefully integrated and planned to ensure an optimal and a safe learning environment for the students. The specific preferences and needs of the unique healthcare disciplines and educational subjects could be examined. A theory-based framework could be considered in designing future pedagogy. These future directions could allow educators to initiate vital change agents in guiding, supporting and nurturing students across generations.